USA Powerlifting Club Registration

Each approved club will have a personalized banner mailed to you with your club name for you to hang at your gym and/or bring to your competitions.

You will select either a 3x5 (Portrait) or a 5x3 (Landscape) layout.

USA Powerlifting Membership Required.

If you are not currently a member, or if your membership has expired, please go to the USA Powerlifting website and submit your USA Powerlifting Membership Application prior to completing your Club Registration.

Current Membership is required for each club member.

Name of Club*

Is this a High School or Collegiate Team?*

Is the team affiliated with the High School/University?

YesNo

Name of School

City, State of School

Club President's Name

First NameLast Name

Club Coach's Name

First NameLast Name

Club President's USAPL #

Club Coach's USAPL #

Club Banner*

E-mail*

Confirmation Email

CLUB LOGO

Upload any logos you would like approved to wear at a USA Powerlifting event. This includes anything text or logo imprinted on any part of the apparel, (shirt front, back, sleeves, singlets, belts, socks, headbands, etc).

Logos are subject to approval.

Primary Club Logo

pdf, jpg, jpeg, png

Upload Secondary Club Logo(s)

Browse File(s)

pdf, jpg, jpeg, png

Phone Number:*

Area CodePhone Number

Club Address: Please no PO Boxes as our courier will not deliver to PO Boxes only physical addresses.*

Street Address

Street Address Line 2

CityState

Zip CodeCountry

Is club address different then the mailing address for the club secretary?*

YesNo

Mailing Address (for certificate & banner): Please no PO Boxes as our courier will not deliver to PO Boxes only physical addresses.

Street Address

Street Address Line 2

CityState

Zip CodeCountry

You must have a minimum of three [3] members.

Club Secretary to be listed first below.

Member Name*

USAPL #*

Member Name*

USAPL #*

Member Name*

USAPL #*

Member Name

USAPL #*

Member Name

USAPL #*

Member Name

USAPL #*

Member Name

USAPL #*

Member Name

USAPL #*

Member Name

USAPL #*

Member Name

USAPL #*

Member Name

USAPL #*

Member Name

USAPL #*

Member Name

USAPL #*

Member Name

USAPL #*

Member Name

USAPL #*

Member Name

USAPL #*

Member Name

USAPL #*

Member Name

USAPL #

Registration expires at the end of the current calendar year. Registrations received in Nov/Dec will be processed in the following year.

All club registration is subject to approval.

Enter the message as it's shown*

Club Payment

USA Powerlifting Club Registration$95.00

Additional Banner$50.00

Quantity

Total $0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

USA Powerlifting Club Registration

Club Members

Registration expires at the end of the current calendar year. Registrations received in Nov/Dec will be processed in the following year.